ArticleBMC pediatrics2021
Growth patterns and clinical outcomes in association with breastfeeding duration in HIV exposed and unexposed infants: a cohort study in KwaZulu Natal, South Africa.
Article in BMC pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 22 citations in OpenAlex.
- Association between infant feeding practices and infant growth by maternal HIV and antiretroviral therapy status: a prospective study in Cape Town, South Africa.BMC pregnancy and childbirth · 2026Article
- Article
- Comparative growth of children who are HIV-exposed and uninfected with those who are HIV-unexposed and uninfected at age 1 and 2 years in South Africa: a prospective cohort study.EClinicalMedicine · 2025Article
- Differences in growth trajectories in breastfed HIV-exposed uninfected and HIV-unexposed infants in Kenya: An observational cohort study.PLoS medicine · 2025Observational
- Growth Patterns of HIV-Exposed and -Unexposed Infants in African Countries: A Systematic Review and Meta-Analysis.Children (Basel, Switzerland) · 2025Review
- The Linda Kizazi study: a comparison of morbidity and mortality from birth to 2 years between children who are HIV-unexposed and HIV-exposed, uninfected in the era of universal antiretroviral therapy.BMJ global health · 2025Article
- Dietary intake and growth of HIV exposed and unexposed 6-12 months old infants in South Africa.Maternal & child nutrition · 2025Article
- Growth-promoting hormonal alterations in pregnant women living with HIV receiving dolutegravir-based antiretroviral treatment are associated with lower infant 1-year weight z-scores.Frontiers in pediatrics · 2025Article
- Gut microbiota and other factors associated with increased T cell regulation in HIV-exposed uninfected infants.Frontiers in immunology · 2025Article
- Care of the Child Perinatally Exposed to Human Immunodeficiency Virus.Clinics in perinatology · 2024Review
- Risk and rates of hospitalisation in young children: A prospective study of a South African birth cohort.PLOS global public health · 2024Article
- Differences in Breastfeeding Duration by Maternal HIV Status: A Pooled Analysis of Nationally Representative Surveys in Sub-Saharan Africa.Journal of acquired immune deficiency syndromes (1999) · 2024Article
- Effects of Maternal HIV Infection on Early Kaposi Sarcoma-Associated Herpesvirus Seroconversion in a Kenyan Mother-Infant Cohort.The Journal of infectious diseases · 2023Article
- Neurodevelopment among children exposed to HIV and uninfected in sub-Saharan Africa.Journal of the International AIDS Society · 2023Article
- Article
- Growth patterns of infants with in- utero HIV and ARV exposure in Cape Town, South Africa and Lusaka, Zambia.BMC public health · 2022Observational
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundExclusive breastfeeding for 6 months and breastfeeding with complementary feeds until 12 months for HIV exposed and uninfected (HEU) infants or 24 months for HIV unexposed (HU) infants is the current World Health Organisation (WHO) recommendation for low and middle income countries (LMICs) to improve clinical outcomes and growth trajectories in infants. In a post-hoc evaluation of HEU and HU cohorts, we examine growth patterns and clinical outcomes in the first 9 months of infancy in association with breastfeeding duration.
methodsTwo cohorts of infants, HEU and HU from a low-socioeconomic township in South Africa, were evaluated from birth until 9 months of age. Clinical, anthropometric and infant feeding data were analysed. Standard descriptive statistics and regression analysis were performed to determine the effect of HIV exposure and breastfeeding duration on growth and clinical outcomes.
resultsIncluded in this secondary analysis were 123 HEU and 157 HU infants breastfed for a median of 26 and 14 weeks respectively. Median WLZ score was significantly (p < 0.001) lower in HEU than HU infants at 3, 6 and 9 months (- 0.19 vs 2.09; - 0.81 vs 0.28; 0.05 vs 0.97 respectively). The median LAZ score was significantly lower among HU infants at 3 and 6 months (- 1.63 vs 0.91, p < 0.001; - 0.37 vs 0.51, p < 0.01) and a significantly higher proportion of HU was classified as stunted (LAZ < -2SD) at 3 and 6 months (3.9% vs 44.9%, p < 0.001; 4.8% vs 20.9%, p < 0.001 respectively) independent of breastfeeding duration. A higher proportion of HEU infants experienced one or more episodes of skin rash (44.5% vs 12.8%) and upper respiratory tract infection (URTI) (30.1% vs 10.9%) (p < 0.0001). In a multivariable analysis, the odds of occurrence of wasting, skin rash, URTI or any clinical adverse event in HEU infants were 2.86, 7.06, 3.01 and 8.89 times higher than HU infants after adjusting for breastfeeding duration.
conclusionOur study has generated additional evidence that HEU infants are at substantial risk of infectious morbidity and decreased growth trajectories however we have further demonstrated that these adverse outcomes were independent of breastfeeding duration.
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